The core is often defined as the area from the diaphragm to the pelvic floor. Based on functional anatomy that view may need to be redefined. Through my clinical experience I have seen structures in the thorax such as the lungs, the pleura dome restrictions affect “core” function. Suture restrictions in the cranium also affect “core” function as do restrictions of the tentorium. Foot dysfunctions also affect pelvic floor function, hence core function. Any structure in the body that does allow for the tentorium, diaphragm, pelvis and feet to all line up under each other will affect “core” function.

Based on such information it is important for the function from head to toe be looked at when assessing and correcting “core” function.

Basil Butcher is an Integrative Movement Enhancement Specialist based in New York City and his specialty is rebuilding/reconditioning people’s bodies who are in pain and/or want to improve their fitness/performance.

Women consistently have complaints of poor core function following a pregnancy and are offered Kegel exercises or other abdominal exercises to correct these dysfunctions. Despite these type of exercises the complaints persist for many years after the pregnancy and can exacerbated if the woman has multiple pregnancies.  There are solutions to these conditions in the form of  an Integrative Core Conditioning Approach. This system consists of the following:

• Visceral manipulation of  affected Abdominal and Pelvic organs and ligaments
• Neural manipulation of nerve restrictions
• Vascular manipulation of artery and vein restrictions
• New Manual Articular Approach of restricted joints of hips and spine
• Core Activation coupled with proper respiration strategies
• Integration of core function in all functional movement patterns such as squatting, lunging, stepping, pushing, pulling, twisting, bending, walking, jogging and running

To learn more about Visceral, Neural manipulation and New manual Articular Approach you can go to this link

www.barralinstitute.com/about/index.php

Basil Butcher is an Integrative Movement Enhancement Specialist based in New York City. He specializes in taking his clients from pain to the playing field of life and/or sport.

Shin splints or medial tibial stress syndrome (MTSS) refers to pain along or just behind the tibia (shinbone), the large bone in the front of the lower leg. Shin splints occur during physical activity and result from too much force on the shinbone and connective tissue attaching muscles to it. Shin splints are common in runners and in those who participate in activities with sudden stops and starts, such as basketball, soccer or tennis; along with sports that apply extreme pressure to the legs, such as gymnastics. Ten to fifteen percent of running injuries are shin splints.  (From Wikipedia).

I was watching a women’s cricket match in New York two weekends ago and during the game I attended to at least 4 women all suffering with shin splints.  There was a common theme to the pain of each woman’s shin splints the muscles surrounding the hip bone (femur head) that provide stability and mobility of the hip complex were not functioning. These muscles glutes (maximus, medius and minimus), deep hip rotators and core muscles must play their roles as stabilizers, mobilizers to prevent lower leg problems. However for these muscles to play their roles optimally the femur head (hip bone) must sit centrated in the acetabulum (hip socket) so it can maintain its unique instantaneous axis of rotation. Once the femur head is in its proper position all the muscles crossing the joint would have the optimal length and tension relationships and exercises to strengthen the area will work and shin splints would no longer be an issue.

Here are some steps one can follow to achieve hip function that would lessen/prevent the chances of suffering from shin splints:

1. Core activation and breathing  - Core Activation and Diaphragmatic Breathing
2. Psoas activation -Psoas Activation
3. Piriformis release – Piriformis Release
4. Glute & Hip Strengthening – Hip/Glute Strengthening
5. Deep Glute Activation – Deep Glute Activation
6. Single Leg Squat -Single Leg Squat

Manual therapy may be needed prior to following the above guide to release your hip capsule/muscles and lower leg muscles.

Basil Butcher is an Integrative Movement Enhancement Specialist based in New York City and his specialty is rebuilding/reconditioning people’s bodies who are in pain and/or want to improve their fitness/performance.

One of the first recommendations given to an obese or overweight person is to add exercise to your lifestyle and a good start is walking or jogging. The aim of this blog is to examine such a recommendation. Let us look at the some of the biomechanical challenges of walking and/or jogging.  In normal gait one generates 3 times their body weight of  force crossing the hip joints and when someone jogs the force goes up.  Now if someone has proper mechanics from foot up and minimal compensation their body welcomes these forces and dissipates them efficiently.  It is important to understand that the “steering wheel” of the leg is the hip joint so dysfunction at the hip joint would affect  the joints below (knee and foot) and above (lumbar, thoracic spine and shoulder girdle). To add to this in the case of many women whose hips are wider (which are great for child bearing, but not for efficient force generation) are more predisposed to hip instability, thus knee, lower leg and back problems with being of average weight. Also another factor for proper functioning gait patterns is respiration and core function which in the non-obese population is atypical much less the obese population.

When an overweight or obese person walks they engage in strategies that change normal gait patterns because their hips cannot handle the increased compressive forces and do not have the strength to drive 3 times the body weight. As a result there is excessive compensation throughout their body and any activity that increases compressive forces repeatedly across the hips like long walking or jogging would be contraindicated. Other strategies to get an obese person active without compromising their joints would be a preferred methodology.  Methods that are low impact and unloading of their hips, knees and feet would be where to start and as they lose weight and improve their stability, mobility and strength more progressive exercises would be included in their program.

Basil Butcher is an Integrative Performance Enhancement Coach and has a private practice in New York City for the last 12 years.

The thyroid gland has an important affect on the rate of metabolism in the body by the production of a hormone called T4 and the peripheral conversion of T4 into the more metabolically active T3 or reverse T3.  The hypothalamus is constantly checking the need for more metabolic energy in body and in response to falling levels of T4 and T3 it releases a hormone called Thyroid Releasing Hormone (TRH). The only significant role of TSH is that it stimulates the thyroid gland to produce thyroid hormone. This is a simple understanding of the regulation of thyroid hormone; when the brain tissue is exposed to more thyroid hormone the hypothalamus produces less TRH. The pituitary gland then produces less TSH and the thyroid makes less thyroid hormone.

THYROID HORMONES:

The three hormones that the thyroid gland secretes are the following:

• Thyroxin (T4) – Deficiencies of zinc, copper and vitamins A, B2, B3, B6 and C will cause a decrease in production of T4 by the follicles of the thyroid gland.
• Triiodothronine (T3) – Is the most metabolically active thyroid hormone 4-5 times more than T4. About 80-85% of T3 is produced outside the thyroid by conversion of T4 in the liver and kidneys and the enzyme responsible for this conversion is selenium dependent 5’-deiodinase.
• Calcitonin this hormone is involved with calcium metabolism

EFFECT S OF THYROID HORMONES:

• Increase cellular metabolic activity by increasing the number and activity of mitochondria
• Promote growth and development
• Stimulates carbohydrate metabolism
• Stimulates fat metabolism
• Has an effect on plasma and liver fats
• Increases basal metabolic rate
• Decreases body weight
• Has an effect on the cardiovascular system- increase of blood flow, cardiac output, heart rate and heart strength
• Increases respiration
• Increases gastrointestinal motility
• Excitatory effect of the central nervous system
• Increases the rate of secretion of most all other endocrine glands
• Has an effect on sexual function

Thyroid hormone is transported through the blood stream by Thyroid Binding Globulin (TBG) which is produced in the liver. TBG is affected by several factors such as the following:

• Liver dysfunction
• Liver disease
• Oxidative stress, antioxidant insufficiency and lipid peroxidation within liver
• Heavy metals (cadmium, mercury and lead)
• Toxicity: Fluoride, pesticides, radiation, PCBs, dioxins, phthalates
• Medications: Beta blockers, Birth control pills, Estrogen, Lithium, Phenytoin,
• Theophylline, Chemotherapy, Glucocorticoids, Interleukin 6, Clomipramine
• Kidney health

Lifestyle factors also have an effect on peripheral metabolism of thyroid hormones. The following factors have been shown to influence deiodination leading to decreased circulation of T3 levels and increased circulation of rT3 which is not ideal.

• High stress and elevated cortisol levels
• Selenium deficiency

A diet

• High in cruciferous vegetables(goitrogen containing foods)
• Low protein
• Low fat
• Low carb
• Increased alcohol use
• Soy
• Walnuts
• Poor nutrition and nutrient deficiencies: iodine, iron, selenium, zinc vitamins A,B2,B3, B6, B12
• Fasting
• Calorie restriction
• Lack of exercise
• Alcohol intake

It is important to note that enough of these factors will lead to thyroid dysfunction. Often it may not be a lack of thyroid hormone that is the problem, but dysfunction in the liver and/or kidney and associated lifestyle factors that cause the presentation of hypothyroidism.

MANIFESTATIONS OF HYPOTHYROIDISM:

• Fatigue, weight gain, anemia, cold intolerance
• Dry course skin, brittle hair, hair loss, non-pitting edema
• Hearing loss, hoarse voice, periorbital edema, facial puffiness
• Goiter
• Dyspnea, pleural effusions, hypoventilation, sleep apnea
• Bradycardia, congestive heart failure, pericardial effusions
• Anorexia, constipation
• Menstrual disorders, decreased libido, impotence, infertility
• Muscle weakness, delayed ankle jerk relaxation phase
• Depression, psychomotor retardation

Primary Hypothyroidism:

This is a problem located in the thyroid gland when it fails to produce thyroid hormone. It is often preceded by autoimmune thyroid disease.

• TSH levels increased above 2.0
• Normal or decreased total T4 level
• Increased cholesterol

Secondary Hypothyroidism:

In secondary hypothyroidism the problem is due to anterior pituitary hypo function which fails to produce optimum levels of TSH to stimulate the thyroid. Thus thyroid hypo function is secondary to anterior pituitary dysfunction and this condition is becoming more and more common. It is often mistaken for thyroid hypo function.

• A decreased TSH
• A decreased T-3 uptake
• A normal T-4, T-3 and FTI

The likelihood of secondary hypothyroidism increases if serum triglycerides are elevated and total cholesterol are increased.

Tertiary Hypothyroidism:

In tertiary hypothyroidism the hypothalamus shuts down protectively in response to stress and produces low levels of TSH, T4 and T3. This often linked to chronic fatigue syndrome and fibromyalgia. This condition can cause low body temperatures, a tendency towards infections and other metabolic consequences of low thyroid. It has also been suggested that problems with the mitochondria the cellular structures that supply us with energy may cause the suppression of the hypothalamus.

Late Stage Hashimoto’s Disease:

This condition is marked by decreased T4 and gradual hypothyroidism due to the auto-antibodies has already destroyed much of the glandular tissue and there’s not many cells left to produce T4. Now there is adrenal fatigue and hypothyroidism.

CORRECTING HYPOTHYROIDISM:

These are some of the questions that need to be considered:

1.       Does the body have adequate precursors for the synthesis of T4? This would include nutrients such as;

• Iodine
• Tyrosine
• Adequate dietary protein

2.       Is there a need to reduce anti-thyroid antibodies? These would include:

• Gluten more and more evidence points to a connection between gluten intolerance, celiac disease and autoimmune thyroiditis
• There is a relationship between casein or milk protein intolerance and hypothyroidism.

3.       Is there a need to reduce xenobiotics load? Certain environmental toxins can cause autoimmune thyroiditis and research continues to show the role xenobiotics play in thyroid dysfunction.

4.       Is there a need to work on increasing peripheral conversion of T4 into active T3?  Selenium deficiency is a factor here as well as adrenal dysfunction (excess cortisol) interferes with peripheral conversion.

5.       Is there a need to improve the binding of T3 to intracellular receptors? Remember that T3 interacts with intracellular receptors at the level of the mitochondrion to effect energy production. This process requires adequate levels of vitamin A and Omega-3 EFAs (EPA and DHA).

FOODS AND NUTRIENTS THAT SUPPORT T4 SYNTHESIS

1.       Iodine: from fish, sea vegetables like kelp, dulse, arame, hijiki, nori, wakame, kombu and sea salt.

2.       Tyrosine: from eggs, green beans, lean meat (beef and chicken), peas, seafood (fish), sea weed and yogurt.

3.       Zinc: from pumpkin seeds, sunflower seeds, squash seeds, organ meats, shrimp, oysters, herring, green beans, eggs, onion, spinach, chick peas.

4.       Vitamin E: Nuts

5.       Vitamin A : Fish liver oils, animal fats egg yolk, leafy green vegetables, yellow and orange fruits

6.       Vitamin B2: Beef liver, kidney, tuna, chicken, salmon, almonds, avocado.

7.       Vitamin B3: Brewer’s yeast, rice bran, white meat of chicken and turkey

8.       Vitamin B6: Watermelon, banana, chicken, organ meats, leafy green vegetables, legumes

9.       Vitamin C : Citrus fruits and most fruits and vegetables

10.   Copper: liver and other organ meats, eggs, legumes, nuts and raisins

FOODS AND NUTRIENTS THAT SUPPORT PERIPHERAL CONVERSION OF T4 INTO T3:

1.       Zinc

2.       Selenium: brewer’s yeast, organ muscle meats, fish, shellfish, kelp.

FOODS AND NUTRIENTS TO SUPPORT T3 BINDING TO INTRACELLULAR RECEPTORS:

1.       Vitamin A

The key to correcting Hypothyroidism is to detect the underlying causes of the condition and a protocol designed to correct those causes which would include dietary changes, targeted supplementation, detoxification, lifestyle modifications and appropriate exercise.

REFERENCES:

Functional Endocrinology Module:  Functional Medicine University, 2009.

Here are two rules to change:

1.  DO NOT tell anyone about your goals except your supportive loved one(s). Sharing your goals with people who are NOT supportive will sabotage your accomplishing your goal.

2. Once you write your goal down, DO NOT  read them every day but you can take a quick look every once in a while. Simply write down the goal and put it away and relax. Just let go and don’t get attached to the outcome. Just do the work and feel good that you will be eventually achieving all your fitness goals.

Basil Butcher is an Integrative Performance Enhancement Coach and has been in private practice for 11+ years in New York City.

We live in a time that insulin resistance conditions are the order of the day. Insulin resistance is the condition where the body secretes insulin but is unable to use it properly. When insulin sensitive tissues(muscles, fat and liver) fail to respond and lower circulating glucose; the pancreas attempts to secrete greater levels of insulin. The resulting hyperinsulininemia in a person with normal blood glucose concentration is referred to as insulin resistance. Eventually the pancreas fails to keep up with the body’s need for insulin, causing excess glucose to build up in the bloodstream, thus setting the stage for diabetes. Insulin resistance and impaired glucose metabolism is  generally a gradual process that is associated with weight gain and obesity.  The following conditions have been linked to insulin resistance:

• Obesity
• Hypoglycemia
• Hypertension
• Dyslipidemia
• Polycystic ovary syndrome
• Cardiovascular disease
• Diabetes
• Metabolic Syndrome(syndrome X/Dysmetabolic syndrome)
• Glucose intolerance

A Functional Diagnostic Medicine approach to correcting  insulin resistance include the following:

• Nutraceuticals (targeted supplementation based on results of advanced Functional lab testing)
• Exercise – prescribed based on clients physical status a combination of functional strength training/metabolic acceleration training
• Stress management
• Dietary changes based on glycemic index, glycemic load and metabolic efficiency

This article will address dietary recommendations for the insulin resistance and diabetes II client. The recommendations are as following:

Reduce or eliminate all forms of simple and refined sugar from that diet

• Sugar and hidden forms of sugar increase blood glucose and insulin levels
• Sugar will reduce your energy levels, decrease your stamina , reduce your immune function, and increase the likelihood of developing diabetes or obesity
• Refined sugar does not have any place in a healthy lifestyle

Eat whole and minimally processed foods in a balanced meal

• Eat a meal that contains protein, healthy fat, real carbohydrates and non-starchy vegetables
• Focus on whole and unprocessed foods. The processing of foods decreases the nutrient value and increases the likelihood of damaged fats, additives and sugar in the food

Eat plenty of good protein as the main focus of the meal

• Good sources of protein include meat, poultry, fish, eggs and legumes
• Eat protein sources that are anti-biotic, growth hormone free, free from chemicals, additives, preservatives and other chemicals
• Make sure your meat, poultry and egg sources are free range and grass fed
• Divide protein intake across the day

Eat plenty of healthy fat

• Healthy fats are undamaged
• Do not eat damaged fats. These include the following; Hydrogenated or partially hydrogenated oil, margarine, deep fried foods, fried snack foods
• Focus on olive oil, coconut oil and butter

Eat real carbohydrates

• Real carbohydrates are ones that can be grown, picked or harvested and are not refined or processed
• Choose carbohydrates that release their sugars slowly. Those are carbohydrates with a glycemic index below 50 and low to moderate glycemic load.

Focus on non-starchy vegetables

• Non starchy foods are high in fiber and nutrients
• Such as the following;
• lettuce
• leafy greens
• broccoli
• cabbage
• cauliflower
• egg plant
• peppers
• onions and garlic
• summer squash

Recommended sweeteners

• Stevia
• Xylitol

These recommendations are one of the steps to correcting insulin resistance conditions.  This link will help you to refine your diet to get the right protein +fat/carbohydrate ratio that is unique to your bio-individuality.  Fine tuning guidelines

References:

Dysglycemia Portal Module: Functional Medicine University, 2010.

Blood Sugar Regulation Module: FM Town Training Center, 2010.

The popular language used when people are weight/strength training is splitting their training sessions based on body parts, hence the focus is training muscle groups rather than movements. However the human body moves based on the recruitment of sequences of muscles(movement patterns) to allow for any movement, thus the question Train the Muscle or the Movement. Let  us look at the two approaches;

• Train the muscle means that one looks at the muscle/muscle group in isolation rather than part of an integrated unit
• Train the movement  means one looks as the body as an integrated unit
• Train the muscle approach often focuses on the muscles that move the joint and not on the muscles that stabilize the joint
• Train the movement approach takes into consideration the flexibility/mobility, stability and strength of muscles that move and stabilize joints
• Train the muscle approach often leads to pain and injury because such things like static/dynamic posture is not considered, core function is not considered( a six-pack does not equate to a functional core) and mobility and stability of joints are not a consideration
• Train the movement approach takes into consideration static/dynamic posture, core function not ab aesthetics and joint mobility and stability
• Train the muscle is often based on aesthetics only
• Train the movement is about enhancing performance/function and aesthetics is also a benefit not the focus
• Train the muscle approach is not injury preventative
• Train the movement approach is injury preventative

A key feature in Train the Muscle approach is the overuse of fixed axis machines such as leg press, Smith machines, leg extension, hamstring curl machines etc. and overuse of such machines can lead to overuse injuries. Also they do not train the stabilizers they actually sedate the nervous system due to artificial stabilization of the machines. Whereas Train the Movement approach features limited of no use of fixed axis machines and uses primarily free weight (dumbbells and barbells), kettle bells, TRX, Cable machines, Keiser equipment, Swiss balls , med balls etc. allowing for the enhanced nervous system stimulation, thus more muscle recruitment for enhanced performance for life/sport and yes enhanced aesthetic  look.

A Train the Movement approach tip for planning one’s training is simply ascending or descending the following movement patterns or combination of; squatting, lunging, bending, twisting, pushing/pressing, pulling, step-up and gait(walking, jogging or running). For example ascending a squat pattern would be overhead squats with a bar, dumbbells or kettle bells or descending the pattern would be leaning against a Swiss ball on the wall and squat.

Author: Basil Butcher is an Integrative Performance Enhancement Coach in private practice in New York for the past 11+ years.

References:

Program Design Correspondence Course, Chek Institute

Advanced Program Design Correspondence Course, Chek Institute

Clinical Biomechanics: Musculoskeletal Actions and Reactions,  R.C. Schafer D.C.

Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation, Donald A. Neumann

Mechanics of Sport, Gerry Carr

The first challenge to a person who suffers from chronic pain or aches is what do I do to remain active without causing further damage. This is where Corrective Exercise based on a model that approaches the body as an integrated organism and follows the dictum train the movement not the muscles is a solution. Pain is caused simply by the disruption of smooth functioning of the kinetic chain (human body) whether its moving or static. The challenge of the Corrective Exercise Specialist is to detect the source of the pain through a thorough evaluation and design a program to correct the dysfunction(s) to reduce or eliminate the pain. It is important to understand that the source of pain barring trauma to the location is caused by a dysfunction elsewhere in the body and this is where conventional physical therapy and other conventional rehab modalities fail patients/clients because they only address the symptom (pain) and not the cause. Thus chronic pain conditions are more typical than atypical. These are some sources of the disruption of the smooth functioning of the kinetic chain;

• Overuse of chest(costal ) breathing patterns
• Eye dysfunctions
• Poor mouth health
• Poor hearing
• Upper cervical spine and TMJ dysfunction
• Past injuries
• Trigger points
• Organ dysfunction
• Emotional issues
• Dietary factors

Let us look briefly at each of these factors above and how they interrupt the smooth functioning of the kinetic chain which can result in pain.

1. Overuse of chest breathing patterns. Chest breathing patterns are appropriate when we exert ourselves or we are in a stressful situation, however it becomes an issue if we remain in that pattern when we are more relaxed state or at rest. That is not diaphragmatically breathing. Every muscle that attaches to the rib cage are assessory respiratory muscles and in the event we overuse chest breathing patterns they become tight and can develop trigger points. This causes postural changes and affects core function hence there is movement compensation which can lead to pain.
2. Eye dysfunctions for example tracking problems would alter posture (a weight shift in the direction of the better eye). The eye is our most important proprioceptor for survival and the brain would conture  the body to afford eyes are level with the horizon. This affects balance and there is compensation throughout the kinetic chain which again can lead to pain.
3. Teeth issues such as fillings and other issues can affect organ, muscle and joint function. See www.wholebodydentistry.com. This can lead to muscular pain. I have had several clients with pain that after referring them to a whole body dentist and clearing up their teeth issues the pain was gone and the muscle function was restored.
4. Poor hearing affects posture similarly like eyesight ones body would shift to the side of better hearing, thus starting compensation throughout the kinetic chain which can lead to pain.
5. Upper cervical spine sub-luxation affects the functioning of the rest of the spine as well as several body systems. There is a whole field of chiropractic that is dedicated to upper cervical sub-luxations called NUCCA. TMJ which is the Termandibular Joint (jaw) dysfunction is a source of headaches and can cause cervical spine dysfunction and shoulder girdle dysfunction and eventual pain.
6. Past injuries which would have caused pain hence compensation in kinetic chain and if those kinetic chain compensations were not addressed in rehab the chances of suffering that injury again are pretty good.
7. Trigger points are tender points in muscles that radiate to other areas of the body causing pain such as several cervical muscles trigger points cause headaches or a trigger point in the soleus muscle(calf) can cause pain in your sacro-iliac joint (tail bone). Janet Travell did the seminal work on the subject.
8. Organ dysfunction causes pain by affecting muscle function by what is called visceral – somatic reflexes. Organs also develop trigger points that refer into muscles causing pain. For example for a woman reproductive organ dysfunctions can cause pain from the lower back to the toes.
9. Eastern medicine and other indigenous culture has documented how emotions affect various muscle function and organ function. According to Eastern medicine the diaphragm is a muscle we dump emotion issues into and if diaphragm function is impaired the entire kinetic chain function is compromised. According to the Maori people of New Zealand we dump our emotions also into our lower legs.  I personally have seen some interesting emotional responses upon the release of the diaphragm such as the feeling of lightness describing a weight have been taken off their shoulders is a common one. Such releases allows for the restoration of core function and enhanced diaphragmatic breathing.
10. Dietary factors the ingestion of processed food, foods that one has a sensitivity or intolerance to causes an imflammatory response in the gut which causes the brain to shut down the nerve innervations to the gut. Inflammation to the brain means pain. The abdominal wall shares the same nerve root for innervation as the gut and unfortunately the brain does not shut off one innervtion for another it shuts the nerve root off so abdominal muscle function is compromised. Try this experiment test your abdominal wall function and then eat a spicy meal an recheck about 1-2 hours after the meal and note the difference in abdominal wall function especially if your are sensitive to spicy foods.

Author: Basil Butcher  is an Integrative Performance Enhancement Coach and he maintains a private practice in New York City.

References:

Jean-Pierre Barral D.O., Understanding the Messages of Your Body: How to interpret Physical and Emotional Signals to Achieve Optimal Health

Paul Chek, Eat, Move and be Healthy

C.H.E.K. Level 3 Manual, Chek Institute

Blandine Calais-Germain, Anatomy of  Breathing

Carrie M. Hall, Lori Thein Brody, Therapeutic Exercise; Moving Toward Function

Thomas W. Myers, Anatomy Trains

Donald Neumann, Kinesiology of the Musculoskeletal System; Foundations for Physical Rehabilitation

Francis Marion Pottenger, Symptoms of Visceral Disease

R.C. Schafer D.C., F.I.C.C., Clinical Biomechanics; Musculoskeletal Actions and Reactions

R. Louis Schultz PhD, Rosemary Feitis D.O., The Endless Web; Fascial Anatomy and Physical Reality

Dicken Weatherby N.D., Signs and Symptoms Analysis from a Functional Perspective

Thomas A. Wilson, Jeff Falkel, Sports Vision; Training for Better Performance

Janet Travell, Myofacial Pain and Dysfunction; The Trigger Point Manual Vol 1 & 2

Obesity has become epidemic like here in the United States and is becoming a world wide problem and along with it has grown a weight loss cottage industry. It almost seems everyday a new weight loss diet fad or exercise fad hits the media  and  this has  caused confusion among potential consumers which approach is best for their situation. Obesity has been correlated with several factors by research and these factors together or sometimes singularly can cause obesity. The factors that have contributed to the obesity epidemic are the following:

• Poor dietary choices
• Poor exercise habits/Sedentary lifestyles
• Body systems dysfunction
• Lifestyle status, family, relationships, mental, emotional and spiritual issues

As varied these factors are so is each person’s pathway to obesity, thus when integrating any corrective solution to any and all of these factors is must be specific to the individual’s unique obesity pathway and status if long term success is the goal.

Implementation of corrective solutions to obesity is where we often have a hit or miss approach leading to frustration with regaining most or all the weight back after short term weight loss so let us look at a more systematic approach for long term success.

NUTRITION

It has been shown that  fructose, refined carbohydrate products, trans and hydrogenated oils/fats and artificial sweeteners are causative factors of obesity in terms of nutrition. Also it must be noted that the above nutrients reek havoc in disturbing body systems functioning. Thus avoiding or implementing a process of eventual elimination of these obesity causing nutrients from one’s diet is important for long term weight loss success. The next step is implementing a nutrition plan that allows for weight loss and health enhancement over the long term. Such a plan would include good protein sources (plant and animal), carbohydrates (fruits, vegetables and fiber) and fats (omega 3,6,9 fatty acids, small amounts of good saturated fats such as coconut oil/butter, ghee or palm oil). It must be noted that this author advocates organic produce and grass fed animal protein sources. Also drinking adequate amounts of good quality water daily and there is varying schools of thought on the amounts, however let the color of your urine(pee) be your guide. If your urine is a light amber or colorless you are drinking adequate amount of water. Another rule of thumb is drinking at least half your body weight in ounces of water daily so for example if you are 200 lbs then 100 ounces(3 liters) of water would be the minimum you need to drink daily.

Another nutritional strategy for weight loss is calories the old adage that if one expends more calories than one ingests = weight loss. However  it is the hormonal response to everything one ingests is the more important factor for weight loss and health enhancement. This is simply how the body functions; “To say someone “overeats” or “eats a lot” immediately raises the question, compare with whom? One of the most reproducible findings in obesity research, as I’ve said, is that fat people on average, eat no more than lean people. (From Good Calories, Bad Calories by Gary Taubes). Food sensitivities and intolerances also elicit immune, inflammatory and hormonal stress response to the detriment of the individual at a sub-clinical level, therefore it is important to educate one’s client about the responses to a meal that is good or bad.

Good and bad responses after 1-2 hours after a meal

• Appetite – Not hungry Good,  Still hungry Bad
• Cravings – Loss craving/none Good, Still craving  Bad
• Physical – Better/improved Good, Same or worse Bad
• Energy – Better/improved Good, Same or worse Bad
• Mind – Better/improved Good, Same or worse Bad
• Emotions – Better/improved Good, Same or worse Bad

Thus nutritional strategies for long term weight loss and health enhancement must also factor in food choices that are based on overall hormone responses to ingestion to those food choices and throw the calorie is a calorie strategy to the wayside.

Nutritional Strategies for fat loss

• Eat breakfast within 15 minutes of waking up (gets your metabolism rolling)
• Eat a significant breakfast containing protein, carbohydrates, good fats
• Every meal and snack should contain protein, carbohydrates and good fats
• Note your responses 1-2 hours after a meal as outlined above
• Avoid sugar, fructose, refined carbohydrates, trans and hydrogenated fats/oils
• Eat at regular intervals it could be 3-4 hours everyone is different

FAT LOSS EXERCISE

There is a difference between exercise to lose weight versus exercise to reduce fat.  A sound fat loss reduction exercise program enhances muscle growth while reducing fat, whereas a weight loss program is simply about losing weight and often participants in such exercise  programs also lose muscle in the process. The basis for exercise program design were the following principles;

• The human body’s preferred fuel for energy at rest is fat
• The human body responds well to exercise with short bursts that depletes its muscular glygogen stores. Such exercise causes a metabolic disturbance and continues to burn calories up to 38 hours after exercise and you know which energy source it being used the preferred fuel at rest fat!
• Aerobic cardiovascular exercise of moderate intensity preferred fuel is fat, however the body’s response is to create more fat for fuel from dietary sources for the next time.
• Low intensity cardiovascular exercise like walking preferred fuel is carbohydrates like high short burst exercise.

Here is an example and process of taking a 250 lb woman through a fat loss exercise program following a comprehensive assessment of her structure and functional movement skills.

1. First phase of her exercise program, base conditioning is to develop and enhance flexibility/mobility, joint/core stability and requisite strength required to do the movement patterns for daily living (squatting, lunging, pushing, pulling, twisting, bending, stepping up and walking, jogging and running). Exercise choices included floor exercises, Swiss ball exercises, TRX exercises, cable exercises and walking.  Exercise session duration would be 20-45 minutes 3-4 times a week and sets of 40-50 seconds and short rest periods 30-90 seconds between sets or rest as needed. Program variables would include station to station training, super-setting and circuit training. Note she would be encouraged to take walks beginning with 15-30 minutes duration and increase duration as her conditioning improves. No running because she would not have the requisite hip, leg and core strength for running and it is typical to see an “average weight” women not having the requisite strength in these areas thus when they run consistently knee, back and lower leg pain is often the result.
2. The following phases are built onto each other and the intensity increases using modalities of metabolic acceleration training and functional strength training. Formats of circuit training, density training, super sets, tri-sets with sets lasting from 30-50 seconds with short rest periods 30-90 seconds and low intensity days of walking or leisure pace cycling.
3. I cannot emphasize more strongly that before embarking on any exercise program check with your physician and you must enhance/develop your flexibility/mobility, core and joint strength/stability as part of any exercise program or pain will be inevitable!

FAT LOSS EXERCISE STRATEGIES

• Corrective exercise and stretching/mobilization must be part of base conditioning to enhance joint/core strength and stability for more progressive exercise and prevents pain/injury
• Metabolic acceleration training/functional strength training has been shown by research to be the most efficient exercise modality for fat loss, followed by anaerobic cardiovascular training, then aerobic interval training, steady state aerobic cardiovascular training.
• Protocol for metabolic acceleration training can be 5-8 stations working for 30 seconds at each station and resting only when you have completed the desired number of stations for 30-90 seconds and repeat up to 5 times. Density or circuit functional strength training choose 5 -6 exercises including an explosive exercise and reps are 10-12 lasting 40-50 seconds do continuously for desired block of time 10-30 minutes(density training) or do the circuit(circuit strength training) and rest for 30-90 seconds and repeat as many as 4-5 times. This can be done 3-4 times a week with 2 metabolic acceleration training days and 2 functional strength training days.
• Add walking to the program as a low intensity day for 30-60 minutes.

BODY SYSTEM DYSFUNCTION

There are several body system dysfunctions that are resistant to long term fat loss or fat loss  and some of these systems are as follows:

• Inefficient/dysfunctional Gastro-intestinal tract
• Dysfunctional detoxification systems(particularly liver/gall bladder. kidney and colon insufficiencies
• Neuro-transmitter imbalances
• Adrenal exhaustion/Fatigue
• Metabolic Syndrome/Thyroid insufficiencies particularly Hypothyroidism
• Hormonal imbalances

These imbalances are detected through Functional lab testing and questionnaires and once detected a protocol to correct them is recommended. Such a protocol would include targeted supplementation, nutrition modification, lifestyle modification and a Functional Detoxification.

Putting these three pillars as the foundation of your long term fat loss program will enable success! Along with your understanding of change.